PC2 You Decide — A Five-Step Approach to the Personal Choice Interview, Risk Assessment, and Patient Education
PC2 You Decide is designed to guide providers in helping women choose a new contraceptive method and address concerns that their patients might have about the cardiovascular risks associated with combined hormonal contraception.
The five steps of PC2 You Decide entail:
- Patient concerns — Focus on the woman’s agenda for her visit.
- Choices — Find out what options are acceptable to her.
- Personal profile — Collect and interpret facts that may influence the suitability of her preferences (lifestyle, personal factors, health history).
- Considerations — Discuss benefits, side effects, and risks of her preferred method(s).
- You Decide — Partner with her in making the final decision. Give her supporting information and the contact information she needs for Q & A and follow-up care.
Download a PDF example of PC2 You Decide.
The example below focuses on pregnancy prevention, combined hormonal contraception, and cardiovascular risks, but any other subject — obesity, mental health problems, etc. — could be addressed with this approach. Like SOAP notes, the PC2 You Decide approach can be used intuitively by providers to guide them through comprehensive discussions with their patients in a timely manner.
|Five-Step Approach to Interviewing and Patient Education
||Guiding Discussion for Contraception
|Step 1 (subjective)|
- What are your pregnancy plans for the next year? The next five years?
- How would you feel if you were to get pregnant in the next 12 months?
- How important is it for you to prevent a pregnancy, now?
- What would you do if you got pregnant in the next 12 months?
||Patient History Form|
(Patient should complete before the patient/provider interview)
|Step 2 (subjective)|
- Are you currently using a method/methods of contraception?
- How satisfied/dissatisfied are you with this method?
- Are you interested in a new/different method?
- What are your needs for sexually transmitted infection (STI) protection?
||Contraceptive Efficacy Tools|
|Step 3 (subjective and some objective)|
Factors that contribute to contraceptive choices and successful use (Provider reviews the
completed Self-Administered Patient History Form as a guide for the discussion.)
- Ability to remember/keep track of schedules
- Access to health care facility
- Age/cognitive abilities
- Blood pressure
- Comfort with one’s body
- Cultural/religious influences
- Findings of physical examination (if done)
- Habits – smoking, ETOH (alcohol), drugs
- Influence of others — partner(s), parents, friends
- Medical history
- Menstrual profile
- Surgical history
- Sexual behaviors
|Step 4 (assessment)|
Questions & Answers
- Benefits — including non-contraceptive benefits
- Side effects — what is client willing to tolerate
- Weight gain, irregular or no bleeding
- Evidence-based scientific information
CV Conditions Precluding Use of CHC
- Thrombophlebitis or
- History of deep vein thrombosis or thromboembolic disorder
- Cardiovascular or coronary artery disease
- Valvular heart disease with thrombogenic complications
- Uncontrolled hypertension
- Diabetes with vascular involvement
- Headache with focal aura
- Major surgery with prolonged immobilization
- Glossary of Risk Terms
- Patient Comparison Risk Tools
- Six-Step Plan: Responding to Adverse Medical Announcement
|Step 5 (plan)|
- Contraceptive decisions
- Instructions for contraceptive use
- Red flags — contact your health care provider if you have CV signs/symptoms
- Other health messages
- Follow up
- Periodic reassessment
S–Severe Leg Pains
- Instructions for use
- Warning signs
- Other good health messages
- Provider contact information
- Follow-up appointment